The heat and humidity in Vietnam surpassed even the record-setting days that Michael had experienced at Bellevue during July and August. He had because of the humidity in the barracks slept fitfully, and was drenched with perspiration when he woke up at five o’clock. Dressed in fatigues and a t-shirt he made his way to breakfast and felt that he was actually living in the sauna..After making morning rounds in the infirmary, he thought perhaps taking a shower would at least temporarily lower his body temperature . .The coolness of the water flowing over his head was so refreshing.Suddenly he heard a sound which was to be part of every day in Vietnam. The whirling blades of the choppers spawned immediate activity within his barracks. All the stuff members raced to the triage area. Quickly drying off his body he rapidly dressed and joined his colleagues.

As the wounded Marines were transported from the choppers to the triage area nurses and physicians immediately decided who could be treated , and who was so severely wounded that there were beyond help .One Marine had most of his brain exposed, and a nurse held his hand, and did her best to comfort him in his last few minutes of life. The nurses and physicians appeared to have a sixth sense about how and who was to be treated immediately. Michael was stunned by the injuries, and their severity. He emulated the rest of the staff members and began to involve himself in the treatment and decision-making.

The next helicopter unloaded a headless Marine, two with severe vascular injuries and two others missing limbs. Michael realized that the traditional medical approach to trauma was woefully inept, and as Colonel. Bultz had said” even in a major city like New York you would never see this number and degree of injuries”.Performing a tracheotomy on one the wounded he was amazed at the response of the young nurses in the triage area. Many of them were in their early 20’s and barely out of nursing school. They were the backbone of the triage process, and often the last person to speak with a Marine in the final minutes of his life Michael had learned long ago that excellent medical care dependent on a collegial approach, and nurses were vital to excellent health outcomes.That belief was never more true than in this war zone..

That first triage experience was to be repeated day in and day out , and Michael’was counseled by his fellow physicians to avoid against personalizing each patient. This advice was offered with all good intentions ,,and he was advised to see them not us kids from Iowa ,Indiana, New York or any other state but as cases of multiple surgeries to be treated. One physician told him” if you personalize their lives you will be overwhelmed by the horror of this war.” Michael did not easily dismiss this counsel but it went against the very fiber of his personality and spiritual beliefs. He tried to implement a detached approach, but quickly reverted to what had been at the core of his personal and medical history.

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